Enrollment & Credentialing Coordinator

Nira Medical

About The Position

The Enrollment & Credentialing Coordinator plays a critical role in ensuring Nira Medical’s providers, locations, and services are fully credentialed, contracted, and revenue-ready across all payers. This role manages provider enrollment, contract updates, and payer-related operational tasks needed to support new hires, new locations, acquisitions, and organizational expansion. The coordinator ensures timely provider enrollment, contract execution, and adherence to payer requirements while proactively resolving credentialing- or contracting-related issues that may impact revenue. This position requires a hands-on, process-driven mindset with the ability to problem-solve, build scalable workflows, and collaborate effectively with providers, payers, and internal teams. As part of a growing RCM structure, the role is ideal for someone who thrives in a fast-paced environment and can help strengthen Nira’s credentialing foundation with structure, accuracy, and operational discipline. The coordinator partners cross functionally with RCM, Operations, Billing, Corporate Development, and external payer partners to ensure compliance and support the organization’s evolving revenue cycle needs.

Requirements

Associate’s/bachelor’s degree in healthcare administration, business, or a related field; or equivalent relevant experience in credentialing, payer contracting, or healthcare operations
Minimum 4+ years of experience in provider credentialing, and payer enrollment
Strong knowledge of payer credentialing requirements, and individual/group contract structures
Minimum 3+ years of experience in revenue cycle management, healthcare regulations and/or compliance standards
Proactive, self-motivated, and adaptable to the evolving needs of a growing organization
Strong problem-solving skills and ability to work independently
Excellent relationship management and negotiation skills
Ability to collaborate in a data-driven, customer focused team environment

Nice To Haves

Experience working in a startup, scaling healthcare organization, fast-paced RCM environments, with multi-specialty practices or MSO structures preferred
Certified Provider Credentialing Specialist (CPCS) certification, and Athena EHR experience is a plus
Experience with multi-specialty practices or MSO structures preferred

Responsibilities

Ensures all providers are fully credentialed and enrolled in accordance with state, federal, and payer-specific regulations.
Maintains an accurate credentialing database, tracking expirations and renewals, and managing complete enrollment workflows with Medicare, Medicaid, and commercial payers.
Oversees CAQH maintenance, NPI and PECOS updates, and payer portal applications while monitoring enrollment timelines and following up with payers to prevent delays.
Ensures all supporting documentation is kept current, organized, and accessible to internal teams who rely on enrollment status for revenue readiness.
Ensures compliance with all payer credentialing requirements and regulatory standards while maintaining clean, audit-ready credentialing files.
Prepares reports for leadership, supports internal and external audits, and keeps a centralized tracking system with real-time updates on application status.
Ensures that documentation, payer correspondence, and operational updates are consistently accurate, organized, and compliant.
Serves as a key liaison between providers, payers, and internal revenue cycle teams, facilitating timely issue resolution and clear communication.
Provides education to providers regarding reimbursement structures, contract terms, and credentialing expectations, ensuring that both clinical and operational stakeholders understand the impact of payer requirements on revenue and compliance.
Partners closely with RCM teams to ensure provider enrollment and credentialing processes do not disrupt cash flow or claim submission readiness.
Identifies and resolves credentialing-related payment issues, supports onboarding for new providers and practice locations, coordinates payer setup requirements with IT and EMR teams, and escalates enrollment risks when needed.
Plays a critical part in ensuring operational continuity and financial performance during provider or location transitions.
Manages all facility-level and operational changes that must be communicated to payers, including address updates, NPI/TIN linkages, Pay-To and Billing address changes, and the addition of new locations to existing contracts.
Submits required documentation, tracks payer acknowledgments or approvals, and ensures updates are fully processed to prevent revenue disruption.